Impact of the COVID-19 pandemic on remote mental healthcare and prescribing in psychiatry

Abstract During the COVID-19 pandemic, mental health services often used remote technology to deliver care. However, the rise in remote consultation was largely unplanned. Furthermore, while many patients found remote technology a useful way to access care, others did not. Going forwards, remote technology will continue to play an important role in the delivery of mental healthcare. Research on the most effective ways for mental health services to implement remote technology is thus urgently needed. Electronic health records (EHRs) have been widely adopted in mental healthcare services. EHRs not only support individual patient care, but also open the door to largescale research through the analysis of de-identified clinical data. The South London and Maudsley (SLaM) Biomedical Research Centre (BRC) Case Register is a large EHR dataset comprising structured and unstructured clinical information on patients receiving specialist mental healthcare. In this talk, I will present findings from an analysis of the SLaM BRC Case Register using the Clinical Record Interactive Search tool (CRIS) to evaluate the uptake of remote mental healthcare during the COVID-19 pandemic and its association with medication prescribing. I will discuss the implications of these findings for psychiatrists delivering community mental healthcare and how mental health services can harness remote technology to optimise clinical outcomes. Disclosure of Interest R. Patel Grant / Research support from: NIHR (NIHR301690); MRC (MR/S003118/1); Academy of Medical Sciences (SGL015/1020); Janssen, Consultant of: Induction Healthcare Ltd; Holmusk

Abstract: Therapeutic Drug Monitoring (TDM), i.e. the measurement of blood levels of antipsychotics, is a well-established clinical routine tool in the treatment with antipsychotics including clozapine. Nevertheless, worldwide there are different utilisation cultures and trends with use of TDM varying from regular to very limited. In order to assess attitudes regarding the use and utility of therapeutic drug monitoring in psychiatry trainees and young psychiatrists, the EPA ECPC Task Force on Communication and Publications is performing an online survey consisting of 12 questions previously validated in a british context to gather data on TDM attitudes, practices, and clinical setting. Apart from capturing early career psychiatrists' current practices and perspectives regarding antipsychotic TDM the goal of this project is to identify predictive factors for future use of therapeutic drug monitoring (TDM). Here we present the preliminary results of our currently ongoing survey.
Disclosure of Interest: G. Schoretsanitis Consultant of: HLS Therapeutics and ThermoFisher

ECP0004
Developing as an independent practitioner in psychiatry J. Wise Brent, CNWL, London, United Kingdom doi: 10.1192/j.eurpsy.2023 Abstract: Dr Wise will help the audience familiarise themselves with the attitudes, atributes and skills neccessary to establish and maintain a practice outside of a state-supported environment, to develop and grow a career, and reduce the risk of burn out.

ECP0005
Developing as an early-career clinician academic after a baby O. Kilic Department of Psychiatry, Bezmialem Vakif University Faculty of Medicine, Istanbul, Türkiye doi: 10.1192/j.eurpsy.2023.197 Abstract: Balancing career and family is a hard job for everyone. Academic life with multiple and conflicting demands on our time necessitates prioritizing among responsibilities. This resonates especially for a woman academic who takes care of a baby. The speaker will address specific challenges of mothers who are in both academia and clinical practice, give reflections and elaborate on patterns and ways of dealing with this challenge. The talk is hoped to promote awareness and discussion on addressing the inner and outer sources and planning one's own way on a career path.

ECP0006
Building a research career in psychiatry: challenges and opportunities S. Guloksuz 1,2 Abstract: In this interactive session, we will attempt to create a roadmap toward a research career in psychiatry, particularly in challenging settings. Participants will be able to share their experiences and ask questions. Through dialectical discourse, we will identify the essential skills and key competencies for a research career and how to develop them through key strategies and practical exercises. We will try to answer these questions and more. "I like research, but I don't know where to start?" "I know writing is important, but how can I make the process less painful and even perhaps enjoy writing?" "There is no research tradition in my workplace; how can I find a mentor?" "How can I build confidence in presenting at scientific conferences?" "It's important to master hard skills, but what could we do with soft skills?" Abstract: During the COVID-19 pandemic, mental health services often used remote technology to deliver care. However, the rise in remote consultation was largely unplanned. Furthermore, while many patients found remote technology a useful way to access care, others did not. Going forwards, remote technology will continue to play an important role in the delivery of mental healthcare. Research on the most effective ways for mental health services to implement remote technology is thus urgently needed. Electronic health records (EHRs) have been widely adopted in mental healthcare services. EHRs not only support individual patient care, but also open the door to largescale research through the analysis of de-identified clinical data. The South London and Maudsley (SLaM) Biomedical Research Centre (BRC) Case Register is a large EHR dataset comprising structured and unstructured clinical information on patients receiving specialist mental healthcare. In this talk, I will present findings from an analysis of the SLaM BRC Case Register using the Clinical Record Interactive Search tool (CRIS) to evaluate the uptake of remote mental healthcare during the COVID-19 pandemic and its association with medication prescribing. I will discuss the implications of these findings for psychiatrists delivering community mental healthcare and how mental health services can harness remote technology to optimise clinical outcomes. Abstract: As a response to the COVID-19 pandemic, in March 2020 a shift to remote consulting for routine primary care and outpatient appointments was instructed. With the aim to inform whether and how remote consultations should continue postpandemic, the London NIHR Applied Research Collaborations (ARCs) conducted a research-grade evaluation of the impact of this shift in London, focusing on cardiology and mental health as exemplar pathways. Quantitative methodology aimed to explore patterns of healthcare use, efficiency, and clinical outcomes using de-identified patientlevel health records datasets in North-West London and South London. Qualitative interviews with clinicians and patients with experience in remote consultations sought to develop a more in-depth understanding of the experience of the move to remote consulting.

ECP0009
Combining remote work and training: the experience of participating in the first Virtual EPA Gaining Experience Programme K. Shalak Lviv Regional Clinical Psychiatric Hospital, Lviv, Ukraine doi: 10.1192/j.eurpsy.2023 Abstract: Each year the European Psychiatric Association offers early career psychiatrists the opportunity to take part in the Gaining Experience programme, a scholarship that funds short observership placements (between 2 and 8 weeks) overseas in different psychiatric institutions across Europe to ECPs who have completed their psychiatric training. However, since COVID-19 was declared by the WHO as a worldwide emergency on 11th March 2020, it was no longer possible to provide offline overseas observerships. Therefore, the Gaining Experience programme changed its format in 2020-2021 and became virtual. It was in this context, that an Ukranian early career psychiatrist was going to participate in the virtual Gaining Experience programme at the Institute of Psychiatry, Psychology & Neuroscience, King's College London (United Kingdom) from December 2021. The observership placement had a particular academic focus, the essence of which was investigating psychotherapy training among ECPs in Ukraine, and to examine how it is included in psychiatry training. The sharing of this example of virtual observership shows that it is possible and feasible high-quality and affordable distance learning for ECPs. This training format can be useful not only during quarantine restrictions, but also in conditions of limited travel opportunities. Abstract: Professional attitudes and ethics skills of physicians are influenced in part by the lessons of medical training. Still, few medical schools and postgraduate training programs introduce a formal curriculum. There is also the hidden curriculum which is influenced by instructions that are implicitly learned by observation of others, the cultural climate, and the social norms. The hidden ethics curriculum in psychiatry resident programs was investigated with qualitative interviews. Patient autonomy (consent for admission, coercive treatments) and ethical problems that arise during the management of difficult patient populations (medical ills, substance users, and frequent fliers) were the most common themes. Psychiatric residents perceive a need for more education on ethical issues. The speaker will present the available knowledge on psychiatry residents' perspectives and the current programs addressing ethics training. This talk is hoped to elicit discussion in preparation for future action and inform a roadmap for addressing ethics training and subsequent educational events during psychiatry undergraduate and postgraduate education.